When Cristina Rodriguez, 34, began researching fertility clinics, she didn't expect to be shamed for wanting another child. Nor did she expect a $48,000 price tag to have that child.
Between Rodriguez and her husband, David, there are six children—none of whom the couple had together. David, who is 20 years older than Rodriguez, has three grown children from a previous relationship, and Rodriguez, three children from a prior marriage. Cristina and David knew getting pregnant naturally wouldn't be an option; David had previously had a vasectomy, and further Rodriguez now has polycystic ovarian syndrome, endometriosis, and a blocked fallopian tube. So, the couple began researching IVF clinics in Atlanta, where they are from.
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After trying multiple local clinics, Rodriguez found CNY Fertility, a predominantly New York-based clinic with an outpost in Georgia. Rodriguez was swayed by the success stories, but a second factor also caught her eye—the cost. This new clinic was one twelfth the price of the initial $48,000 clinic. What was going on?
Join any of the countless infertility groups online, and you're bound to run into a post about CNY. Run by Robert Kiltz, MD, CNY is known for having the lowest prices in the industry. Whereas the average basic in vitro fertilization cycle typically costs $12,400, CNY charges only $3,995. Included in that price is: anesthesia during the egg retrieval, intracytoplasmic sperm injection, assisted hatching, cryopreservation, one year of storage, and a fresh transfer—all services, minus fresh transfer, that typically incur additional fees on top of that $12,400. This pricing structure, unsurprisingly, brings in patients from all over the United States. About half of CNY's patients come from out of state—and about 5% travel internationally.
This new clinic was one twelfth the price of the initial $48,000 clinic. What was going on?
Why is IVF so expensive—except when it’s not?
When asked how he keeps prices so low, Kiltz tells Health there is no secret to it. "We do it because we believe everyone should have access to high quality fertility care. The cost of running a fertility clinic has dropped dramatically since the early days of IVF, but much of those savings have not been shared fairly with the patients."
The first child conceived using IVF was born in 1978. Though it's been more than 40 years since then, IVF has maintained its premium price tag. The average cost of IVF in 1993 was $6,233. But the nearly 30 years change in time has not led to significant savings. Factoring in inflation, were the price to stay the same, IVF should only cost about $10,000 today. And IVF is significantly more expensive than that—in the States, at least. According to a study published in the International Journal of Women's Health, with the exception of Canada, where the average cycle runs around $8,500, the average cost of IVF is typically below $5,500 globally. In the U.K., it's $5,244; Brazil, $3,000; Japan, $3,956; India, between $600 to $1,000; and in South Africa, $4,500. In the States, the average cost is $12,000—but it can easily hit $100,000.
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The most expensive part of running a fertility clinic, Kiltz says, is the lab equipment. It can cost anywhere from $1,812,960 to $3,625,920 to set up a high-quality IVF lab. To keep cycle prices low, there is belief that clinics must become "high-volume" facilities—but Kiltz says this isn't the case.
"Today, our prices certainly attract a large volume of patients, which helps us be more profitable, but you don't need to be high-volume to provide affordable care," he says. "We have been amongst [the most affordable], if not the most affordable fertility clinic for most of the 25 years we have been around. We have been profitable every year since opening, and only in the last five to 10 years became what could be considered a 'high-volume' clinic."
The cost of running a fertility clinic has dropped dramatically since the early days of IVF, but much of those savings have not been shared fairly with the patients.
Funding IVF: Grants, side hustles and more
If you're new to the fertility clinic search, it can be hard to know where to look for affordable options or ways to lower the cost. Anna Wang, 36, estimates she spent $200,000 on fertility treatments—three egg retrievals and four embryo transfers—and associated costs such as acupuncture, bloodwork, ultrasounds, surgeries, and consultations with different doctors. Like most people undergoing IVF, Wang's schedule of procedures and transfers was, in part, determined by finances.
"Life happens whether you are doing IVF or not, so we had to save and budget for our procedures, which delayed the timeline," she tells Health. "I already felt like my biological clock was ticking, so having to put becoming a parent on hold due to finances was very frustrating."
Though Wang and her husband, Jeremy Tu, 35 paid for their treatments out of pocket, they found a creative way to fund their fourth embryo transfer: cheesecakes. Spurred by the pandemic-inspired baking boom, Wang and Tu, who live in Los Angeles, decided to make cheesecakes for their friends. Wang posted about the cakes on her Instagram, where she built a following talking about infertility, and began getting orders.
"We thought to ourselves, What's the harm in baking a few extra and selling them for $30 each to apply the funds towards our upcoming IVF transfer?" Wang says. Wang and Tu quickly raised the $5,000 to $7,000 they needed for their fourth embryo transfer, which resulted in their daughter. "We ended up selling over 400 cheesecakes in one week, which covered the entire IVF transfer. We've never baked a cheesecake before in our lives, but for that week, we were baking, responding to inquiries, and managing deliveries for 18-plus hours each day."
Following their experiences, Wang and Tu wanted to help others looking to expand their families who may not have the means, or culinary prowess, to do so. In the midst of Wang's fertility treatments, the couple began a nonprofit to support folks in the infertility community. Their organization, The Cozy Warrior, began by donating comfy socks to those undergoing fertility treatments, and has since expanded to provide $5,000 grants to patients. Their program is one of a growing list of funds that provides monetary assistance to people trying to build their families. And while these grants can be competitive, the financial boost they provide can pay for an embryo transfer, or at the very least make a dent in your IVF bill.
RELATED: IVF Costs Can Approach $100K—Here's How One Woman Saved Thousands
“Mini” IVF and other clinic deals
Beyond giveaways, there are other "deals" to be found in the fertility community. More than half of US clinics offer package deals that guarantee a child or your money back. But buyer beware. You have to apply for these programs, and those accepted are typically people who already have a high likelihood of conceiving through IVF.
"Best we can tell, these package deals and refund programs are generally offered to the people most likely to succeed in treatment, and thus are the least likely to receive the benefit," says Jake Anderson-Bialis, co-founder of FertilityIQ. "What's interesting is that many patients don't seem to care. They like the 'downside protection,' though it appears the price tag on that peace of mind is incredibly high. The $20,000 to $30,000 they probably lose out, if wisely invested over 18 years, would probably pay for that child's college tuition."
More than half of US clinics…guarantee a child or your money back. But buyer beware.
If you don't have insurance or can't travel to a more affordable clinic, check and see if your clinic offers "micro" or "mini" IVF. Mini IVF uses less ovarian stimulation medication than a conventional IVF cycle, which can bring down the cost of both your clinic and medication bill. Because less medication is used, fewer eggs are typically received—but studies suggest the pregnancy rate is comparable to conventional IVF for those above the age of 35, previous poor response, or diminished ovarian reserve. And clinics tend to charge less for these cycles since they require less monitoring and resources.
For those with health insurance that covers fertility services, or who live in a state that mandates insurance providers cover treatment, your best option is to look for a clinic that takes insurance.
"Historically the self-pay cash rates are higher than insurance reimbursement, which may not be incentivizing the doctor to accept insurance if they're being paid less for the same cycle," says Annbeth Eschbach, president of Kindbody. Kindbody is one of a growing number of clinics that accepts insurance; Eschbach says roughly one-third of their patients pay this way.
As for Rodriguez, she found success at CNY and became pregnant with her daughter after her second frozen embryo transfer. Though the road was challenging (she developed ovarian hyperstimulation syndrome after her retrieval and had a difficult pregnancy and delivery) she's happy with the way things turned out—including the $3,995 price tag.